中医特色疗法对全膝关节置换术后快速康复的临床疗效观察

发布时间：2018-03-29 20:48

  本文选题：全膝关节置换　切入点：中医特色疗法　出处：《广州中医药大学》2017年硕士论文

【摘要】：目的:以全膝关节置换术后患者为研究对象,结合快速康复外科,应用中医特色疗法,观察手术后患者膝关节功能评分、疼痛评分等专科情况以及排气时间、下地时间、睡眠质量等一般情况与对照组的差别,观察中医特色疗法结合快速康复外科应用于全膝关节置换术后患者的有效性及安全性,从而促进全膝关节置换术后患者康复。方法:选取2016年2月起至2017年2月在广州中医药大学第三附属医院关节科行人工全膝关节置换并符合纳入标准的患者60人。随机分配为治疗组及对照组,两组均实行快速康复外科模式,治疗组再配合中医特色疗法(耳穴压籽、穴位贴敷、吴茱萸热包)。两组病人均由同一组医疗团队按照同一手术方式(膝前正中切口切开皮肤,经髌骨内侧切口切开关节囊,后交叉韧带替代型膝关节假体)行不置换髌骨的单侧人工全膝关节置换术。对两组患者一般资料进行对比及作统计学分析,确定一般资料无统计学差异,基线水平一致,具有可比性。记录两组患者术后膝关节功能评分、疼痛评分等专科情况以及排气时间、下地时间、睡眠质量等一般情况。通过数据的收集、统计和分析,评估两组资料的差异,得出初步结论。结果:1.膝关节KSS功能评分方面,两组术前评分分别为53.03±4.80和52.90±4.54,统计学分析无显著统计学差异(P0.05);术后3d治疗组评分为68.93±3.22,对照组评分为67.47±1.50,术后3d的KSS评分差异具有统计学意义(P0.05)。术后7d治疗组评分为81.40±2.79,对照组评分为79.73±3.47,术后7d的KSS评分差异具有统计学意义(P0.05)。术后14d治疗组评分为87.97±2.09,对照组评分为87.10±2.17,术后14d的KSS评分差异无统计学意义(P0.05)。2.疼痛VAS评分方面,两组术前评分分别为7.00±0.95和7.07±0.91,统计学分析无显著统计学差异(P0.05);术后3d治疗组评分为4.13±0.90,对照组评分为3.87±0.90,术后3d的VAS评分差异无统计学意义(P0.05)。术后7d治疗组评分为3.43±0.50,对照组评分为3.37±0.49,术后7d的VAS评分差异无统计学意义(P0.05)。术后14d治疗组评分为3.03±0.49,对照组评分为2.90±0.55,术后14d的VAS评分差异无统计学意义(P0.05)。3.匹兹堡睡眠评分方面,两组术前睡眠评分分别为9.93±2.45和10.30±2.55,统计学分析无显著统计学差异(P0.05)。术后14d两组评分均有明显改善,治疗组评分差值为3.70±2.02,对照组评分差值为2.37±2.87,睡眠评分差值两组对比具有统计学意义(P0.05)。4.并发症发生方面,治疗组患者30例中,5例出现患肢肿胀,2例出现患肢僵硬,并发症发生率23.33%,对照组患者30例中,8例出现患肢肿胀,3例出现患肢僵硬,并发症发生率36.67%。无感染、切口延迟愈合、深静脉血栓等其他并发症发生。5.术后排气时间方面,治疗组排气时间为9.70±3.72小时,对照组排气时间为18.4±4.12小时,排气时间差异具有显著统计学意义(P0.01)。6.术后下地时间方面,治疗组术后下地时间为2.23±0.82天,对照组术后下地时间为2.93± 1.17天,术后下地时间差异有显著统计学意义(P0.01)。7.住院费用方面,治疗组住院费用为70854.68±8068.11元,对照组住院费用为76286.52±6483.30元,住院费用差异有显著统计学意义(P0.01)。结论:在全膝关节置换术后应用中医特色疗法可促进膝关节功能康复,促进胃肠功能恢复,改善睡眠,缩短下地时间,减少住院费用。中医特色疗法进一步促进快速康复外科对术后康复的疗效,适合在临床应用。
[Abstract]:Objective: to total knee arthroplasty patients as the research object, combined with rapid rehabilitation surgery, application of TCM therapy, scores of patients with knee joint function were observed after surgery, pain score and other specialist and exhaust time, ambulation time, difference in sleep quality in general and the control group, observation combined with rapid rehabilitation surgery on the safety and efficacy of total knee arthroplasty in patients with the therapy of Chinese medicine, so as to promote the rehabilitation of patients after total knee arthroplasty. Methods: from February 2016 to February 2017 in the Third Affiliated Hospital of Guangzhou University of Chinese Medicine Department of joint for total knee arthroplasty and met the inclusion criteria of 60 patients who were randomly assigned to treatment group and. The control group, the two groups are subject to rapid rehabilitation surgery model, treatment group with TCM therapy (auricular plaster therapy, acupoint application, Wu Zhuyu hot pack). The two groups of patients by The same group of medical team in accordance with the same surgical approach (anterior median incision of the skin, the patella medial incision capsulotomy, posterior cruciate ligament replacement knee prosthesis replacement of the patella) for unilateral total knee arthroplasty. The general data of two groups of patients were statistically analyzed to determine the general ratio of. There was no significant difference in baseline data, consistent with comparable records. The knee joint function of two groups of patients with postoperative pain score, score of college and exhaust time, ambulation time, sleep quality generally. Through data collection, statistics and analysis, differences in the assessment of two sets of data, draw preliminary conclusions. Results: 1. KSS knee function score, two groups preoperative scores were 53.03 + 4.80 and 52.90 + 4.54, no statistically significant statistical difference (P0.05); postoperative 3D score was 68.93 + 3.22 treatment group, control group 璇勫垎涓，

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